Non melanoma skin cancer (NMSC) can be seen as a multifaceted problem, considered primarily as a public health problem whose impact on society considers the morbidity and cost aspects of the treatment. It is a social problem, affecting all those who depend exclusively on the Brazilian public health system and need to wait months to receive any type of treatment. From the economic point of view, to treat all patients diagnosed with NMSC, it is necessary a big investment. Finally, the problem is logistical, since the territorial extension of Brazil and its population distribution do not enable the adequate care in all the places, which requires reallocation of patients from small cities to reference centers. Based on these facts, PDT for small skin lesions may be one of the best solutions from an economic point of view. Being a treatment that is easy for the training of professionals and enables to be performed in an ambulatory environment, minimizing post-treatment effects, this study shows that the cost of implementing the procedure on a large scale is extremely adequate for the national public health service. Using a strategy involving companies, national bank and medical partners, equipment, medication and protocols were tested in a multicenter study. With results collected over 5 years from a national program to implement PDT for non melanoma skin cancer over the Brazilian territory, we could reach a great economic evaluation of advances concerning the use of PDT for skin cancer.
A new PDI protocol is presented in this study. C. albicans cells pre-illuminated with a low dose light demonstrated an increase of curcumin uptake when compared to dark incubation, leading to a higher PDI efficacy.
This study clearly demonstrates that multispectral confocal microscopy images analyzed by artificial neural networks
provides a powerful tool to real-time monitoring photosensitizer uptake, as well as photochemical transformations
occurred.
Onychomycosis is a common disease of the nail plate, constituting approximately half of all cases of nail infection. Onychomycosis diagnosis is challenging because it is hard to distinguish from other diseases of the nail lamina such as psoriasis, lichen ruber or eczematous nails. The existing methods of diagnostics so far consist of clinical and laboratory analysis, such as: Direct Mycological examination and culture, PCR and histopathology with PAS staining. However, they all share certain disadvantages in terms of sensitivity and specificity, time delay, or cost.
This study aimed to evaluate the use of infrared and fluorescence imaging as new non-invasive diagnostic tools in patients with suspected onychomycosis, and compare them with established techniques.
For fluorescence analysis, a Clinical Evince (MM Optics®) was used, which consists of an optical assembly with UV LED light source wavelength 400 nm ± 10 nm and the maximum light intensity: 40 mW/cm2 ± 20%. For infrared analysis, a Fluke® Camera FKL model Ti400 was used. Patients with onychomycosis and control group were analyzed for comparison. The fluorescence images were processed using MATLAB® routines, and infrared images were analyzed using the SmartView® 3.6 software analysis provided by the company Fluke®.
The results demonstrated that both infrared and fluorescence could be complementary to diagnose different types of onychomycosis lesions. The simplicity of operation, quick response and non-invasive assessment of the nail patients in real time, are important factors to be consider for an implementation.
Onychomycosis is the most common nail disorder. The treatment for this type of infection is one of the main difficult ones in clinical practice, due to the fact that the nails are nonvascularized structures, which compromise the penetration of drugs delivered systemically and favor slow nail growth. We present two devices based on light-emitting diode arrays as light sources for the treatment of onychomycosis by photodynamic therapy (PDT). PDT is an emerging technique that uses a photosensitizer (PS) activated by light in the presence of oxygen. The PS absorbs energy from light and transfers it to oxygen, producing reactive oxygen species such as hydroxyl radicals, superoxide, and singlet oxygen which inactivate fungi and bacteria. Our proposal is the use of a portable and secure light source device in patients with onychomycosis. Additional advantages are the low cost involved, the possibility of topical treatment rather than systemic and the simplicity of operation. These advantages are important to ensure the implementation of this technology for the treatment of an impacting health problem.
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